FILLINGS / RESTORATIONS

Overview

A Filling/restoration is a way to restore damaged tooth back to its normal function and shape. Tooth damage may be caused because of decay (caries), fracture/chipping off, grinding, abrasion etc.

How do I Know I need a Filling?

The only person who can really tell you if you need a filling is a dentist. They will need to examine your tooth closely, take x-rays and determine what needs to be done.

However, there are a few signs that can alert you to the fact that you may require a filling.

These include:

  • Pain in the tooth, including throbbing or sharp pain sensations while eating food, taking liquids, rinsing.
  • Pain or sensitivity in the tooth when you touch it or breathe in air or put pressure on it (e.g. when eating, brushing)
  • A visible hole or mark that might indicate a hole exists
  • Food getting stuck on or between your teeth
  • Dental floss that keeps fraying when you floss between a particular set of teeth
  • A rough or jagged feeling in the tooth when you run your tongue over it

If you don’t experience any of these symptoms, it is still possible that tooth decay may be present and that you will need a filling. This is often the case with smaller holes that may exist in your teeth.

For instance in the pic here, there may not necessarily be any sign that alerts the person that there is a cavity. If left untreated, however, these cavities expand silently within the tooth and progress to a point where the tooth cannot be restored just by a filling.
So, the best way to stay abreast of any teeth cavities is to ensure you visit a dentist every 6 months for a check-up.

What Happens If You Ignore the Need for a Filling?

If you fail to visit your dentist regularly or if you choose not to go ahead with a filling (for whatever reasons), the effect on your teeth can be very damaging:

  • Your tooth will continue to rot and decay
  • This can cause you a great amount of pain and make eating (and other tasks) difficult or uncomfortable
  • If left untreated, the cavity will become large, forcing the tooth to decay on a greater scale, and a root canal treatment or tooth extraction may be the only way to resolve the problem
  • Large cavities may end up causing more serious infections such as abscesses, gum infections
  • May weaken the tooth structure so much that it breaks or chips-off
What happens when you get a filling done – step-by-step procedure

Restoring a tooth to good form and function requires the following steps

  • Giving anaesthesia (if required)
  • removal of decayed portion
  • Isolating with rubberdam or cotton
  • Placement of filling material
  • Adjustment according to your bite patterns
  • Polishing
Which Type of Filling is Best?

A Filling/restoration is a way to restore damaged tooth back to its normal function and shape. Tooth damage may be caused because of decay (caries), fracture/chipping off, grinding, abrasion etc.

No one type of filling is best for everyone. What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost.

There are several restorative materials which may be used, which include

  • Gold fillings
    • Highly pure gold or gold alloy foils can be used for direct filling. It’s well tolerated by gum tissues, and may last more than 20 years. However, it is the most expensive option and is technique sensitive. It is rarely, if ever, done these days.
  • Amalgam (silver) fillings
    • As the name suggests, amalgam fillings are made up of a mixture of metals. They typically contain about 50 percent mercury, along with tin, copper, silver or zinc.
    • Amalgam fillings are the least pricey and typically have great strength and are resistant to wear and fracture. Hence they can last for 10-20yrs or more.
    • These fillings are silver in colour to start with and tend to become darker with time, meaning they are a fairly conspicuous item when you open your mouth.
    • However, use of this material is highly controversial. Presence of mercury in it has raised concerns about possible mercury toxicity.
    • Also, amalgam fillings are also believed to cause/propagate micro-cracks in the tooth structure, ultimately leading the tooth to fracture (with the filling still remaining intact). In several countries, its use has been restricted or completely banned. At Dentedge, amalgam fillings are not done.
  • Composite (plastic) resins
    • Also called as ‘laser’ fillings
    • It can be matched to the colour of a person's existing teeth, making it much less visible.
    • As more people want natural-looking smiles, composite fillings have become increasingly popular.
    • Composites are perfect in small fillings, and best suited for teeth that experience a moderate amount of pressure when chewing
    • However, this type of filling isn't always the right pick.
    • Though the new composite materials provide great strength as well as aesthetics, the material strength is still less than that of amalgam.
    • So, composite fillings will typically last for a far less time than an amalgam one, if done in large cavities or where there is greater chewing pressure.
    • Also, composites are filled by placing multiple thin layers and hardening each layer with a blue light. This process is therefore more time consuming and technique sensitive than an amalgam or GIC filling.
    • Another drawback is that these fillings become stained from coffee, tea, tobacco etc and require to be polished every 6 months to one year for maintaining proper aesthetics.
  • GIC ( Glass Ionomer Cement)
    • These are white or cream coloured materials.
    • They bond chemically to dental hard tissues and release fluoride for a relatively long period which helps prevent further decay of teeth.
    • Though they are tooth coloured, however, exact shade matching is not possible with these materials.
    • These properties of glass ionomer cements make them useful materials in the restoration of carious lesions in low-stress areas, primary teeth (milk teeth), wisdom teeth, cases where composites cannot be done
  • Miracle Mix/ Zirconomer :
    • These are silver/zirconia reinforced GIC filling materials, and are typically bluish and whitish in colour respectively. They provide superior strength as compared to composites and are used in large cavities and posterior teeth where aesthetics are of no major concern.
  • Temporary filling material :
    • Temporary fillings are just that; they are not meant to last. They usually fall out, fracture, or wear out within a month. Temporary fillings are used under the following circumstances:
      • For fillings that require more than one appointment -- for example, in indirect fillings.
      • Following a root canal session
      • To allow a tooth's nerve to "settle down" if the pulp became irritated
      • If emergency dental treatment is needed (such as to address a toothache)

Be sure to contact your dentist to have a temporary filling replaced with a permanent one. If you don't, the tooth could become infected or you could have other complications.

How should I care for my teeth with fillings - Post Restoration Care and Maintenance
  • Chewing: Some restorations do not develop their maximum strength for 24 hours. Chew only soft foods on the new restorations until that time. As with natural unrestored teeth, avoid chewing excessively hard foods such as hard candy, corn nuts, ice and other hard objects that may break the restoration or remaining natural tooth structure.
  • Sensitivity: Due to the size and type of the restoration you may experience mild sensitivity to hot and cold. This sensitivity should disappear in a few weeks. If it does not do so, or should it get worse, contact your dentist. This sensitivity or other mild discomfort can sometimes be caused by a high spot in your bite or a very deep filing which is close to the nerves.
  • The Future: We expect several years of service from these restorations. However, at times, large restorations may break or the tooth structure around them may break. If breakage occurs, the involved tooth or teeth may require a crown for optimum strength.
  • Problems: If one or more of the following conditions occur, contact your dentist immediately to avoid further problems:
    • A feeling of movement or looseness in the restoration.
    • Sensitivity from sweet foods.
    • A peculiar taste from the restoration site.
    • Breakage of a piece of material from the restoration.
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